Abstract

A 5-year-old child was referred for persistent cyanosis (oxygen saturation of 88%) after an episode of pneumonia. The anteroposterior chest roentgenogram showed a dilatation of the right upper mediastinum (*) (Fig 1A). The transthoracic echocardiogram, subcostal projection, revealed an obstructive supracardiac total anomalous pulmonary venous connection (TAPVC); all pulmonary veins connected with the innominate vein through a vertical vein. However, the innominate vein was significantly narrowed distally, close to the innominate/right superior vena cava (SVC) junction, and the SVC was severely dilated (poststenotic turbulence at the innominate/SVC junction; Fig 1B).

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